Managing and Keeping Healthcare Professionals

by Professor Rene T. Domingo

Health care institutions, particularly hospitals, need to be managed well to be viable and achieve their social goals. Skilled professionals and managers should provide the needed leadership and strategic thinking to effectively run these complex organizations, which are characterized by scarce resources, demanding customers, and high-pressure environment. The health care industry, however, will have to compete with other industries for these talents as they are produced by the tertiary education schools and universities. Most medical school graduates eventually work in health care institutions as their first jobs, though some get employed in other industries. However, few graduates outside medicine accounting, engineering, business management, - are attracted to working in health care establishments, especially hospitals. There are three major reasons for this lack of interest:

Hospitals and other health care institutions, running 24/7, are perceived as high-stress working environments, where quality of life are almost always compromised by regular overtimes, night-shifts, double-shift assignments, and week-end duties. Moreover, having to deal with demanding patients and doctors add to the stress from long and unpredictable working hours. In fact, medical staffs, in spite of their training to work extended hours, quit their jobs because of burn-out. They either retire early or move to less stressful industries. Non-medical staff will certainly have much lower thresholds and staying power.

Secondly, healthcare establishments are usually non-profit organizations. Many are religious and government run. Consequently, pay is not competitive nor attractive. Hospitals are not perceived as greener pastures to move to. Talents cannot be lured with higher pay, because most health care organizations, being non-profit, do not buy the concept of recovering return on investments from this premium pay. Non-standard pay is considered disruptive in this regulated industry.

Thirdly, there is very little career opportunity in most health care institutions, which have relatively flat organizations. In the private corporate world, career runways are longer with milestones such as assistant managers, assistants-to, and several levels of vice presidents to look forward to by aspiring staff. These are absent in most hospitals, where middle management is lean. After lower management and department heads comes senior management - the medical director, hospital administrator, and the CEO. Top management in hospitals is usually vacated only by old-age retirement, seldom by incompetence or the availability of younger talents in the pipeline.

Given these handicaps of health care establishments, we still can find mission-oriented professionals and individuals willing to forgo opportunities offered by the corporate world, and dedicating their working lives to serving the sick and suffering. However, most new graduates of tertiary schools, particularly those from the non-medical fields and sciences, may not be as socially-inclined in choosing their first jobs. Given this universal situation, health care establishments should consider the following steps and strategies to compete more effectively in the job market for talents and skills:

1. Improve pay and incentives; benchmark with other industries; link pay to performance, not just to working hours, and years of service.

2. Design and develop a clear and attractive career path for heath care professionals inside the organization; regularly replenish senior management posts with new blood.

3. Provide stock ownership options to employees. While doctors in private hospitals are usually stockholders, this privilege should also be given to nurses and the non-medical staff.

4. Provide regular training and training opportunities to health care staff and professionals.

Health care establishments will have to invest not only in upgrading equipment and technologies, but also in enhancing their working environments if they are to remain competitive, effective, and relevant.

Rene T. Domingo is a professor and management consultant. Please send comments to



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